Preparing for Bundled Payments: Impact of Complications Post-Coronary Artery Bypass Grafting on Costs.

Preparing for Bundled Payments: Impact of Complications Post-Coronary Artery Bypass Grafting on Costs. Ann Thorac Surg. 2020 Sep 04;: Authors: Haddad DN, Shipe ME, Absi TS, Danter MR, Vyas R, Levack M, Shah AS, Grogan EL, Balsara KR Abstract BACKGROUND: Bundled payments for Coronary Artery Bypass Grafting (CABG) provide a single reimbursement for care provided from admission through 90 days post-discharge. We aim to explore the impact of complications on total institutional costs, as well as the drivers of high costs for index hospitalization. METHODS: We linked clinical and internal cost data for patients undergoing CABG from 2014-2017 at a single institution. We compared unadjusted average variable direct costs, reporting excess cost from an uncomplicated baseline. We stratified by the Society of Thoracic Surgeons preoperative risk and quality outcome measures as well as value-based outcomes (readmission, post-acute care utilization). We performed multivariable linear regression to evaluate drivers of high costs, adjusting for preoperative and intraoperative characteristics and postoperative complications. RESULTS: We reviewed 1,789 patients undergoing CABG with an average of 2.7 vessels (SD 0.89). A significant proportion of patients were diabetic (51.2%) and obese (mean Body Mass Index (BMI) of 30.6, SD 6.1). Factors associated with increased adjusted costs were preoperative renal failure(p=0.001), diabetes(p=0.001) and BMI(p=0.05) and post...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research

Related Links:

ConclusionsPatients with CMS were more likely to present with increased comorbidities. Patients with CMS undergoing CABG were at risk for worse short ‐term secondary postoperative outcomes and reduced long‐term survival. The data supports the need for further investigation for risk reduction surrounding operative revascularization.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
In conclusion, high-dose NR induces the onset of WAT dysfunction, which may in part explain the deterioration of metabolic health. Towards a Rigorous Definition of Cellular Senescence https://www.fightaging.org/archives/2019/11/towards-a-rigorous-definition-of-cellular-senescence/ The accumulation of lingering senescent cells is a significant cause of aging, disrupting tissue function and generating chronic inflammation throughout the body. Even while the first senolytic drugs capable of selectively destroying these cells already exist, and while a number of biotech companies are working on the productio...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
by Jenny C. Censin, Sanne A. E. Peters, Jonas Bovijn, Teresa Ferreira, Sara L. Pulit, Reedik M ägi, Anubha Mahajan, Michael V. Holmes, Cecilia M. Lindgren Obesity traits are causally implicated with risk of cardiometabolic diseases. It remains unclear whether there are similar causal effects of obesity traits on other non-communicable diseases. Also, it is largely unexplored whether there are any sex-specific differences in the causal effects of obe sity traits on cardiometabolic diseases and other leading causes of death. We constructed sex-specific genetic risk scores (GRS) for three obesity traits; body mass index...
Source: PLoS Genetics - Category: Genetics & Stem Cells Authors: Source Type: research
Publication date: March–April 2019Source: Diabetes &Metabolic Syndrome: Clinical Research &Reviews, Volume 13, Issue 2Author(s): Seyedeh Mahdieh Namayandeh, Ahmad Karimi, Hossein Fallahzadeh, Masoud Rahmanian, Seyed Mahmood Sadr Bafghi, Mohammadhosein Soltani, Leila HadianiAbstractBackground and objectivesDiabetes Mellitus (DM) is a metabolic disease characterized by chronic hyperglycemia, which occurs due to insufficient production of insulin by the pancreas or resistance to insulin produced by the body. The most dangerous and Long-term complications of diabetes include renal failure, heart failure, cardiova...
Source: Diabetes and Metabolic Syndrome: Clinical Research and Reviews - Category: Endocrinology Source Type: research
Publication date: Available online 5 February 2019Source: Diabetes &Metabolic Syndrome: Clinical Research &ReviewsAuthor(s): Seyedeh Mahdieh Namayandeh, Ahmad Karimi, Hossein Fallahzadeh, Masoud Rahmanian, Seyed Mahmood Sadr Bafghi, Mohammadhosein Soltani, Leila HadianiAbstractBackground and objectivesDiabetes Mellitus (DM) is a metabolic disease characterized by chronic hyperglycemia, which occurs due to insufficient production of insulin by the pancreas or resistance to insulin produced by the body. The most dangerous and Long-term complications of diabetes include renal failure, heart failure, cardiovascular dis...
Source: Diabetes and Metabolic Syndrome: Clinical Research and Reviews - Category: Endocrinology Source Type: research
Publication date: Available online 14 August 2018Source: Journal of Food and Drug AnalysisAuthor(s): Yu-Ting Kuo, Chih-Chan Lin, Hsiao-Tzu Kuo, Jui-Hsiang Hung, Ching-Hsuan Liu, Alagie Jassey, Ming-Hong Yen, Shu-Jing Wu, Liang-Tzung LinAbstractType 2 diabetes mellitus (T2DM) is a chronic disease characterized by hyperglycemia that can lead to long-term complications including heart diseases, stroke, retinopathy, and renal failure. Treatment strategies include stimulating glucose uptake and controlling blood glucose level. Bofutsushosan (BOF) and Daisaikoto (DAI) are two herb-based kampo medicines that have been demonstrate...
Source: Journal of Food and Drug Analysis - Category: Food Science Source Type: research
Chronic kidney disease (CKD) affects a substantial minority of people with type 2 diabetes (T2D). Analysis of US National Health and Nutrition Examination Survey (NHANES) datasets from 2007 through 2012 showed Stage 3 or worse disease (estimated glomerular filtration rate [eGFR]
Source: Journal of Diabetes - Category: Endocrinology Authors: Tags: Editorial Source Type: research
Contributors : Emilie Stolarczyk ; Charlotte Bailey ; Natividad Garrido-Mesa ; Paul Lavender ; Richard Jenner ; Graham Lord ; Jane HowardSeries Type : Genome binding/occupancy profiling by high throughput sequencingOrganism : Mus musculusThe epidemic of obesity and its associated systemic metabolic complications continues to increase. Adipose tissue (AT)-associated T cells have been proposed to play an important role in the regulation of bodyweight and insulin sensitivity with a link to Th1 or Th2 lineage specification. A specific subset of regulatory T cells (TREGS) plays a critical and non-redundant role in controlling s...
Source: GEO: Gene Expression Omnibus - Category: Genetics & Stem Cells Tags: Genome binding/occupancy profiling by high throughput sequencing Mus musculus Source Type: research
Suboptimal fluid intake may require enhanced release of antidiuretic hormone (ADH) or vasopressin for the maintenance of adequate hydration. Enhanced copeptin levels (reflecting enhanced vasopressin levels) in 25% of the common population are associated with enhanced risk of metabolic syndrome with abdominal obesity, type 2 diabetes, hypertension, coronary artery disease, heart failure, vascular dementia, cognitive impairment, microalbuminuria, chronic kidney disease, inflammatory bowel disease, cancer, and premature mortality. Vasopressin stimulates the release of glucocorticoids which in turn up-regulate the serum- and g...
Source: Kidney and Blood Pressure Research - Category: Urology & Nephrology Source Type: research
ConclusionsThere was a high prevalence of vitamin D deficiency in the elderly, and the evidence shows a strong association between vitamin D deficiency and increased risk of heart failure in this population.
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
More News: Cardiovascular & Thoracic Surgery | Coronary Artery Bypass Graft | Diabetes | Eating Disorders & Weight Management | Endocrinology | Insurance | Obesity | Renal Failure | Stroke